PT  - JOURNAL ARTICLE
AU  - M. Laflamme
AU  - S. Carrondo-Cottin
AU  - M.-M. Valdès
AU  - D. Simonyan
AU  - M.-È. Audet
AU  - J.-L. Gariépy
AU  - M.-C. Camden
AU  - C. Gariépy
AU  - S. Verreault
AU  - P. Lavoie
TI  - Association between Early Ischemic Changes and Collaterals in Acute Stroke: A Retrospective Study
AID  - 10.3174/ajnr.A7632
DP  - 2022 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1424--1430
VI  - 43
IP  - 10
4099  - http://www.ajnr.org/content/43/10/1424.short
4100  - http://www.ajnr.org/content/43/10/1424.full
SO  - Am. J. Neuroradiol.2022 Oct 01; 43
AB  - BACKGROUND AND PURPOSE: The quality of leptomeningeal collaterals may influence the speed of infarct progression in acute stroke. Our main objective was to evaluate the association of leptomeningeal collateral score and its interaction with time with ischemic changes on CT in patients with acute stroke.MATERIALS AND METHODS: Adult patients with acute stroke symptoms and anterior circulation large-vessel occlusion on CTA from 2015 to 2019 were included. Routinely performed NCCT and multiphase CTA were reviewed to assess ASPECTS and the leptomeningeal collateral score. We built multivariate regression models to assess the association between leptomeningeal collateral score and its interaction with time and ASPECTS. Performance measures to predict poor ASPECTS at different time thresholds (identified with receiver operating characteristic curve analysis) were estimated in a subgroup of patients with poor leptomeningeal collateral scores.RESULTS: Leptomeningeal collateral scores 0–1 were associated with lower ASPECTS, and the model with dichotomized and trichotomized leptomeningeal collateral score showed a significant multiplicative interaction between time and the leptomeningeal collateral score. The negative predictive value for poor ASPECTS was >0.9 for at least the first 3 hours from stroke onset to imaging, and the positive predictive value was <0.5 for every time threshold tested in the subgroup of patients with leptomeningeal collateral scores 0–3.CONCLUSIONS: Poor (0–1) leptomeningeal collateral scores were associated with lower ASPECTS, and an increase in time has a multiplicative interaction with the leptomeningeal collateral score on ASPECTS.CollSleptomeningeal collateral scoremCTAmultiphase CTANPVnegative predictive valuePPVpositive predictive valueROCreceiver operating characteristic